The Oakland Score is a tool used to estimate the likelihood of a safe discharge following a lower gastrointestinal (GI) bleed. It evaluates several patient-specific factors by assigning numerical scores, which are then summed to provide an assessment of discharge safety.

Here's how the scoring is done based on each of the patient's characteristics:

Age:
- Under 40 years receives 0 points
- Between 40 and 69 years receives 1 point
- 70 years or older receives 2 points

Sex:
- Female receives 0 points
- Male receives 1 point

Previous admission for lower GI bleeding:
- No prior admission receives 0 points
- Previous admission receives 1 point

Digital rectal examination findings:
- No blood receives 0 points
- Blood present receives 1 point

Heart rate (beats per minute):
- Under 70 receives 0 points
- Between 70 and 89 receives 1 point
- Between 90 and 109 receives 2 points
- 110 or more receives 3 points

Systolic blood pressure (mmHg):
- Between 50 and 89 receives 5 points
- Between 90 and 119 receives 4 points
- Between 120 and 129 receives 3 points
- Between 130 and 159 receives 2 points
- 160 or more receives 0 points

Hemoglobin level (g/dL):
- Between 36 and 69 receives 22 points
- Between 70 and 89 receives 17 points
- Between 90 and 109 receives 13 points
- Between 110 and 129 receives 8 points
- Between 130 and 159 receives 4 points
- 160 or more receives 0 points

By totalling these scores, we derive the Oakland Score, which correlates to the probability of a safe discharge.

The interpretation of the total score offers insight into the discharge likelihood:
- Scores from 0 to 2 suggest a 99% probability of safe discharge.
- Scores of 3 to 4 suggest a 98% probability.
- A score of 5 implies a 97% probability.
- Scores between 6 and 7 suggest a 96% probability.
- A score of 8 implies a 95% probability.
- A score of 9 gives a 93% probability.
- A score of 10 suggests a 91% probability.
- A score of 11 indicates an 89% probability.
- Scores between 12 and 13 indicate a probability ranging from 87% to 89%.
- Scores between 14 and 15 suggest a 77% to 81% probability.
- Scores from 16 to 17 indicate a 67% to 72% probability.
- Scores from 18 to 20 suggest a 50% to 62% probability.
- Scores from 21 to 23 reflect a 33% to 45% probability.
- Scores from 24 to 26 correlate with a 20% to 28% probability.
- Scores from 27 to 29 indicate an 11% to 16% probability.
- Scores of 30 or greater suggest a probability of less than 0.1%.

This scoring method provides a structured approach to determine the likelihood of a safe discharge for patients suffering from lower GI bleeds, enabling informed medical decisions.

The Oakland Score is a clinical calculator used to assess the risk of adverse outcomes in patients who have experienced a lower gastrointestinal (GI) bleed. It is specifically designed to identify patients who are at low risk and can be safely discharged from the hospital. 

The Oakland Score applies to adult patients who have been admitted to the hospital with a lower GI bleed. It is particularly useful in emergency departments and acute care settings, where it can help clinicians make informed decisions about patient management, potentially reducing unnecessary hospital admissions and associated costs.

The score takes into account several factors, including patient age, pulse rate, systolic blood pressure, hemoglobin levels, presentation with syncope, digital rectal examination findings, and comorbidities. 

The Oakland Score is not suitable for use in children or in patients with upper GI bleeding. It should also not be used in isolation but in conjunction with clinical judgment and other relevant diagnostic tools.

Oakland score for safe discharge after lower GI bleed